Healthcare is always a hot-button topic, especially in the United States. No matter what their stance on legislation that's passed or proposed, many Americans would agree that the system needs improvement. In 2011, the U.S. spent about $7,960 per person on healthcare. By contrast, many of the other countries in the OECD (Organization for Economic Co-operation and Development) spent $3,233 per person. And yet the World Health Organization ranks the U.S.'s healthcare system 37th in efficiency. Spending more money doesn't make things better. And we have growing rates of obesity, heart disease, type II diabetes and other diseases that are caused or influenced by poor health habits. Something has to change.
And change it will -- just ask any futurist who makes healthcare forecasts. According to the Association of Professional Futurists, a futurist is a person who "uses foresight to describe what could happen in the future, and in some cases, what should happen in the future." We're not talking about psychic friends here -- futurists are usually scientists, and they study and analyze trends to come up with possible scenarios. They think long-term and big-picture, so current legislation may not even figure into their forecasts. With that in mind, let's take a look at five futurist predictions in the world of health.
One of the issues with healthcare today, some futurists reason, is that it focuses more on reactive medicine. When you get hurt or sick, you go to the doctor and get treatment. That's fine for some things, but if that random pain turns out to be a serious condition, you (and your insurance company) could be paying out a lot of money. That's why healthcare will ultimately shift its focus to preventive instead of reactive care. This means keeping you from getting sick in the first place, as well as catching things early before they become big problems.
Obviously, not everything can be prevented, but you can lessen the risk factors for the most common diseases. Heart disease, for example, is the leading cause of death in the United States. Some of the risk factors include smoking, high cholesterol, high blood pressure, obesity, and inactivity -- and all of them are actionable. But many people don't realize the risks until they have a heart attack. We often ignore warning signs, and we don't always get regular check-ups (sometimes because we can't afford them). We also aren't very good about educating ourselves. Not only is this bad for us personally but it also puts a strain on the system -- treating an illness costs much more in both time and money than taking steps to prevent it in the first place. Futurists like Jim Carroll believe that within the next 10 years or so, wellness programs will be considered an integral part of most organizations. They'll even offer incentives for employees who participate and meet their goals and penalize those who don't.
Some diseases and conditions are hereditary; if you know your family's health history, you know that you have a higher risk of developing them. But even with that knowledge, you could be at risk for something and not be aware of it. One way to find out is to have your genes mapped. The Human Genome Project, completed in 2003, mapped the 20,000 to 25,000 genes that make up our DNA. But this includes all of the variations; each of us has a unique genetic sequence that can reveal whether we have the gene known to cause a certain condition or whether that gene has mutated. If you find out early enough that you carry the gene for a certain type of cancer, for example, you would know what to look for if it develops. Or if you're thinking about having a child, you'll already know whether there's a chance of passing something on.
As of this writing, getting your individual genetic code mapped costs around $3,000 and it takes about a week. That's not exactly accessible for most people, and insurance doesn't cover it. However, advances in technology are driving both the length of time it takes and the cost down -- the current goal is $1,000, which is about the cost of an MRI today. But futurist Michio Kaku believes that soon it will cost about $100 to map your genes and place them on a CD, making it a part of routine medical practice. Your doctor will take a saliva or blood sample and almost instantaneously have a sort of owner's manual for your body. Known as genomic medicine, this practice would allow doctors to both treat illnesses based on your genes and work to prevent you from getting sick in the first place.
Futurists predict that technology will soon be a major player in how we take charge of our own health. Sure, there are apps available now to help you monitor your weight, food intake and other health conditions. But futurist Jim Carroll foresees technology functioning as a "dashboard for the human body" [source: Jim Carroll]. Not only will we be using phone apps -- we'll also be integrating lots of gadgets to help monitor our health. Technologies like scales that measure weight and body fat and send them via WiFi to a Web site, or an armband that measures blood pressure and plugs into an iPhone, will be more common. We'll be able to send this information to doctors so they can monitor our health all of the time.
Even further into the future, Michio Kaku believes that silicon chips could be encoded with DNA and placed in your bathroom mirror: "You blow on the bathroom mirror. It analyzes your saliva droplets, looking for the P53 gene" [source: Medical Device and Diagnostic Industry]. A change in this gene is present in half of the most common cancers. Frank Moss, former director of the M.I.T. Media Lab, sees a future in which software could suggest how you might improve your health, based on your vital signs and other input. A program might direct you to run diagnostic tests on yourself and then send the results to your doctor, who would explain them and prescribe treatment via video. And if you do have to go into a doctors' office, he or she will show you what's happening on a big screen, you'll decide on a course of action together and you'll get instructions sent to your phone. The future of health technology will mean an entirely new doctor-patient relationship.
Regenerative medicine involves healing the body by replacing or regenerating cells, tissues or organs. It includes things like stem-cell and bone-marrow transplants, as well as artificial organs and medical devices. But there are currently some limits to this field. Artificial hearts are only used when a patient is about to die because they simply don't last long enough. If you need a new organ that can be transplanted, like a kidney, you may be on dialysis for years, at a cost of up to $30,000 per year. About 18 people die each day in the U.S. waiting on an organ transplant. Then if you do find a donor and get a new organ, there are issues such as rejection to contend with.
But what if instead of getting a donated organ or implanting an artificial medical device, you could just grow a new organ? Futurists believe that we'll be there in 10 to 20 years. Growing organs will not only save lives; it will also save the cost of treatments. Our aging population will require better and more efficient ways of managing their health, and a sort of "body shop" where you can replace what wears out will contribute to that. It's probably not as far away as you might think. In 2008, British doctors implanted the first engineered organ, a new windpipe that was grown from the patient's own stem cells. We're already using tissue-engineered skin for burn patients, and there are clinical trials growing all kinds of other human cells, organs and tissues, from ears to blood vessels.
If you've ever been admitted to a hospital, you know that for all of our automation, there's still a lot of actual paperwork involved. You may also see lots of different healthcare providers during your stay, and sometimes they may give you conflicting information or not keep appointments. This is just one of the many aspects of a system that is inefficient and ultimately costs you more. Futurist Jack Ulrich predicts that hospitals will become more accountable and efficient by providing coordinated, standardized care.
Some of this has to do with technology. Healthcare providers need to get on board with digitizing everything from patient records to MRIs and electronically tracking things like pharmacy inventory and even people (in the case of, say, an Alzheimer's patient who tends to wander) . Digitization will also let hospitals easily monitor things like outbreaks of illnesses. Providing more efficient care also has to do with working together -- the Patient Protection and Affordable Care Act (PPACA), for example, gives hospitals incentives to form accountable care organizations. These are networks that include doctors, hospitals and clinics that share accountability for the patients' care.
Joe Flower, another healthcare futurist, believes that hospitals will also improve by adopting management tools used in successful businesses, like Six Sigma or the Toyota Production System (yes, the car manufacturer). Some hospitals are already employing this model and report that they're better able to care for a larger number of patients, without the need for more staff or larger facilities.
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Author's Note: 5 Futurist Predictions in the World of Health
I'm excited about the futurist predictions for the world of health. I participate in a wellness program offered by my insurance company, so I think those are a great idea. I use some apps already to keep track of my health, and I'm all for making it easier to do so and to discuss my health with my doctor. There are members of my family who could greatly benefit from advances in tissue and organ engineering. And I've experienced many times the frustration of a healthcare system that isn't standardized and digitized, with doctors' offices that don't coordinate with each other well. While some of these predictions are already coming true and may be commonplace in 10 years or fewer, others probably won't be seen until 20 or more years from now. But I think no matter what it's important to be informed, and I'm always interested in the latest innovations in the world of health.
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